Mg2Si based solid solutions have unique advantages in the direct thermal to electrical energy conversion due to environmentally friendly and abundant constituent elements, and high thermoelectric performance. Further enhancing figure of merit zTof this materials system lies in the reduction of the relatively high lattice thermal conductivity. Alloying by high content of aliovalent Sb (>10%) in Mg2Si can greatly suppress the lattice thermal conductivity, lower than conventional Mg2(Si,Sn) solid solutions, due to the enhanced phonon scattering from Mg vacancy and concomitant strains. In this work, detailed microstructure observation for Sb alloyed Mg2Si reveal the existence of dense dislocations, around which the strip-like defects are viewed with isotropic strain. By introducing dislocations and vacancies as the additional phonon scattering sources, the model calculation can well match the experimental lattice thermal conductivity. The present work offers a comprehensive understanding of the role of vacancies and concomitant strains in reducing thermal conductivity, and may open a new venue for zTenhancement.